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General NPI Number Information
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NPI Number | 1770158743
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Entity Type | Organization
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Legal Business Name | FESSEL CHIROPRACTIC INC.
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Dates
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Enumeration Date | 05/23/2021
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Last Update Date | 05/23/2021
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Provider Practice Location Address
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Address Line | 519 S BROADWAY
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City | SANTA MARIA
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State | CA
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Zip | 93454-5176
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Country | US
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Telephone | 805-925-4569
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 BADEN AVE UNIT B
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City | GROVER BEACH
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State | CA
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Zip | 93433-2703
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Country | US
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Telephone | 760-505-1662
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYAN S FESSEL
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Credential | DC
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Telephone | 760-505-1662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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